Constipation is the main cause of greater pressure in your colon. When you are constipated, your muscles strain to move stool that is too hard. The extra pressure from this straining makes the weak spots in your colon bulge out. These pouches that bulge out are the diverticula.

Experts do not know what causes the infection that leads to diverticulitis. They think the infection may start when stool or bacteria are caught in the diverticula.

Who is at risk for diverticular disease?

Experts don’t know for sure if your diet affects your risk of getting diverticular disease. But you are more at risk for the disease if you:

Are over 50 years old

Are male

Have diverticulosis

Are obese

Don’t get enough exercise

Use nonsteroidal anti-inflammatory drugs (NSAIDS)

Smoke

What are the symptoms of diverticular disease?

Each person’s symptoms may vary. Symptoms may include:

Diverticulosis.You can have diverticulosis and not have any pain or symptoms. But symptoms may include mild cramps, swelling or bloating, and constipation. These symptoms can also be caused by irritable bowel syndrome, stomach ulcers, or other health problems. These symptoms don’t always mean that you have diverticulosis.

Diverticulitis.The most common symptom of diverticulitis is belly or abdominal pain. The most common sign that you have it is feeling sore or sensitive on the left side of your lower belly. If infection is the cause, then you may have fever, nausea, vomiting, chills, cramping, and constipation.

Diverticular colitis. This is when the colon gets inflamed (colitis) as a result of the diverticular disease. This is less common than diverticulitis.

Diverticular bleeding. The most common symptom of diverticular bleeding is painless bleeding from the rectum. You likely will see bright red or maroon-colored blood in your stool.

The symptoms of diverticular disease may look like other health problems. Always see your healthcare provider to be sure.

How is diverticular disease diagnosed?

Your healthcare provider will look at your past health and do a physical exam. He or she may also use some of the following tests:

X-rays. A small amount of radiation is used to make images of body tissues onto film.

Digital rectal exam. This test checks if you have problems in the anus or rectal area. Your healthcare provider will gently put a gloved, lubricated finger into your rectum. Using his or her finger, your healthcare provider will check the muscle that closes off the anus.

A stool sample. This test checks for any abnormal bacteria or parasites in your digestive tract. To do this, a small stool sample is taken and sent to a lab.

CT scan. This test shows detailed images of any part of the body, such as the bones, muscles, fat, and organs. This is used to check for complications of diverticular disease like diverticulitis.

Barium enema.This is also called a lower GI (gastrointestinal) series. This is an X-ray exam of your rectum, the large intestine, and the lower part of your small intestine. You will be given a metallic fluid called barium. Barium coats the organs, so that they can be seen on an X-ray. The barium is put into a tube and inserted into your rectum as an enema. An X-ray of your belly will show if you have any narrowed areas (strictures), blockages, or other problems.

Virtual colonoscopy. This is a CT scan that checks your colon using air and contrast.

Flexible sigmoidoscopy. This test checks the inside of part of your large intestine. It helps to tell what is causing constipation. A short, flexible, lighted tube (sigmoidoscope) is put into your intestine through the rectum. This tube blows air into your intestine to make it swell. This makes it easier to see inside. A tissue sample (biopsy) can be taken if needed.

Colonoscopy. This test looks at the full length of your large intestine. It can help check for any abnormal growths, tissue that is red or swollen, sores (ulcers), or bleeding. A long, flexible, lighted tube (colonoscope) is put into your rectum up into the colon. This tube lets your healthcare provider see the lining of your colon and take out a tissue sample (biopsy) to test it. He or she can also treat some problems that may be found.

How is diverticular disease treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Experts suggest eating 20 to 35 grams of fiber each day. Your healthcare provider may tell you to eat more foods that have fiber, such as:

Whole grain breads, cereals, and other items

Fruit, such as berries, apples, and peaches

Vegetables, such as broccoli, cabbage, spinach, carrots, asparagus, and squash

Beans

Treatment for diverticulitis may also include:

Pain medicines

Medicines to fight infection (antibiotics)

Medicines to control muscle spasms

Letting your colon rest by having a liquid diet and staying in bed

Bowel rest or eating only clear liquids for some time

You may need to stay in the hospital if you have a bad attack with severe pain or infection. In some cases surgery may be needed. If you have an infection in your abdomen, sometimes a tube is placed to drain the pus.

Once diverticulitis heals, a colonoscopy is usually recommended to check the colon.﻿

What are possible complications of diverticular disease?

Possible complications include:

Infection (diverticulitis)

Holes or tears

Blockages

Bleeding (diverticular bleeding)

Colitis (inflammation of the colon)

What can I do to prevent diverticular disease?

Experts don’t know how to keep diverticular disease from happening. But once you have diverticulosis it may be possible to decrease your risk of diverticulitis by eating a high-fiber diet. You do not need to avoid corn, nuts, or seeds.

Living with diverticular disease

If you have diverticulosis, follow your healthcare provider’s advice. Some people with diverticulosis will get diverticulitis. A few will have diverticular bleeding.

When should I call my healthcare provider?

If your symptoms get worse or come back after treatment, call your healthcare provider. You should also call if you notice any bleeding.

Key points about diverticular disease

Diverticular disease is a group of conditions that result from small pouches in the colon. It includes diverticulosis (the pouches), diverticulitis (infection or inflammation of the pouches), and diverticular bleeding.

The most common symptom is belly or abdominal pain.

The most common sign that you have it is feeling tender around the left side of the lower abdomen.

To see if you have diverticular disease, your doctor may order tests that look at your intestine from the outside (such as CT scan or virtual colonoscopy) or inside (such as colonoscopy).

Treatment may include eating more fiber. However, during attacks of diverticulitis, you may be told to remain on clear liquids or low fiber foods for some time.

You may need to stay in the hospital if you have a bad attack with severe pain or infection.